中医临床研究2025，Vol.17Issue(27)：24-30,7.DOI:10.3969/j.issn.1674-7860.2025.27.005
基于"脾为之卫"与"脾虚瘀毒"探讨胃癌的因机证治
Exploring the etiology,pathogenesis,syndrome,and treatment principle of gastric cancer based on the theories of"spleen as the guard"and"spleen deficiency and stasis toxin"
摘要
Abstract
Gastric cancer is a highly prevalent malignant tumor of the digestive system,and its occurrence and development are closely associated with the dysfunction of"spleen as the guard"in traditional Chinese medicine(TCM).The theory of"spleen as the guard"emphasizes that the spleen transports and transforms nutrients,and generates Ying(营)and Wei(卫)to form the body's defensive barrier.Spleen deficiency can lead to impaired defense,resulting in the internal generation of phlegm-dampness and blood stasis,which over time transforms into toxins,forming the core pathogenesis of"spleen deficiency and stasis toxin".Modern research indicates that a spleen-deficient state is highly correlated with immunosuppression and metabolic disorders in the tumor microenvironment,manifesting as suppressed CD8+T cell function,increased regulatory T cells,and excessive secretion of inflammatory factors,etc.In this paper,based on the TCM theories of"spleen as the guard"and"spleen deficiency and stasis toxin",the integrative medicine staged strategy for the diagnosis and treatment of gastric cancer is explored systematically.During the surgical phase,treatment focuses on warming Yang(阳)and strengthening spleen,often selecting prescriptions such as the Sijunzi decoction(四君子汤)to repair post-operative injured spleen and stomach.In the chemotherapy phase,emphasis is placed on fortifying spleen and harmonizing stomach,and resolving stasis and detoxifying,selecting prescriptions such as the Xiangsha Liujunzi decoction(香砂六君子汤)plus the Taohong Siwu decoction(桃红四物汤)to alleviate chemotherapy toxicity.During targeted treatment phase,aimed at the"Yin(阴)deficiency with blood stasis"syndrome,the Shashen Maidong decoction(沙参麦冬汤)is often used to clear heat and nourish Yin.In the immunotherapy phase,treatment involves strengthening spleen and clearing heat,and harmonizing Ying and Wei to mitigate immune-related adverse events.Furthermore,treatment strategies are dynamically adjusted according to different stages of gastric cancer(Stage I,dampness-turbidity accumulation.Stages Ⅱ to Ⅲ,stasis-toxin interaction.Stage Ⅳ,both spleen and kidney deficiency),reflecting the TCM syndrome differentiation and treatment principle of"supporting healthy Qi and eliminating pathogens".Through theoretical elaboration and case analysis,the etiology,pathogenesis,syndrome,and treatment principle of gastric cancer in TCM are explored,providing clinical insights for the prevention and treatment of gastric cancer,and highlighting the unique advantages of"holistic regulation and treatment"of TCM in the comprehensive treatment of tumors.关键词
脾为之卫/脾虚瘀毒/胃癌/中医药Key words
Spleen as the guard/Spleen deficiency and stasis toxin/Gastric cancer/Traditional Chinese medicine分类
医药卫生引用本文复制引用
金漪澜,张卉,张昕睿,徐果,邹玺,刘沈林..基于"脾为之卫"与"脾虚瘀毒"探讨胃癌的因机证治[J].中医临床研究,2025,17(27):24-30,7.基金项目
国家自然科学基金资助项目(81973782) （81973782）
江苏省卫健委项目(ZD2022070) （ZD2022070）
江苏省医学重点实验室(ZDXYS202208). （ZDXYS202208）
